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Health Care Reform: What to Know About the Employer Exchange Notice

Story Content Provided by HealthPass on 8/28/13

As open enrollment for health insurance exchanges grows nearer, employers face a deadline to notify employees about the availability of these new marketplaces. Let's look at who is subject to the requirements, the deadline for notification and other important details.

The Affordable Care Act (ACA) requires employers to provide their employees with a written notice about exchanges to help explain some of the benefits and potential consequences associated with purchasing through an exchange. The Department of Labor has provided guidance indicating that employers must issue these notices as of October 1, 2013.

What employers are subject to the requirement?
The Employer Notice requirements define "employer" very broadly. Anyone who is classified as an "employer" under the Fair Labor Standards Act (FLSA) is subject to the employer notice requirements. Because the standard is so broad, employers should assume they must provide employees with the Employer Notice unless they have reason to believe they are exempt from the FLSA . Additional information on the applicability of the FLSA , including an internet compliance assistance tool , can be found here.

What must be included in the notice?
Model notice forms have been prepared for employers and are available on the Department of Labor's website and can be found below.

Model Notice For Employers That Offer Coverage
Model Notice For Employers That Do Not Offer Coverage

The website provides a model notice form for employers who do not offer a health plan and another model notice form for employers who offer a health plan to some or all employees. These forms do not exceed three-pages in length.

Employers may use one of the models, as applicable, or can choose to use a modified version of their own, so long as the modified version meets the content requirements discussed below.

Under the Department of Labor's guidance, Employer Notices must:

  • Identify the existence of the new exchanges, provide a description of services provided by an exchange and specify exchange contact information;

  • Explain that the employee may be eligible for a premium tax credit if the employee purchases a qualified health plan through the exchange; and

  • Inform the employee that if he purchases a qualified health plan through the exchange, he may lose the employer contribution (if applicable) to insurance provided by the employer.

The employer only needs provide to basic information in the open fields in Part A (Page 1) and B (Pages 2-3).

What employees must receive the notice?
Employers must provide the Employer Notice to all employees, including part-time employees, regardless of whether the employee enrolls in insurance offered by the employer. Further, the Employer Notice must be provided regardless of whether the employer offers insurance.

Upon receiving the form, an employee can review the information provided by his employer and use it as a reference as they weigh the option to purchase coverage within the exchange marketplace.